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RACGP calls for changes to AHPRA immediate action process
The college has raised concerns about the delays faced by GPs subject to immediate action and the subsequent impact on their wellbeing – calling for an update to current processes.
While immediate action may be necessary in some cases, the college says investigation and resolution of these matters is taking ‘far too long’.
Receiving a complaint through the Australian Health Practitioner Regulation Agency (AHPRA), let alone being subject to an immediate action, is among the most stressful experiences doctors report facing during the course of their career.
Health practitioners have expressed frustration with the time taken to receive an outcome, as well as a lack of communication about its progress.
The RACGP has reflected these concerns in its submission to a National Health Practitioner Ombudsman (NHPO) investigation into delay and procedural safeguards for practitioners who are subject to immediate action, citing concerns about timeliness and the subsequent impact on GP wellbeing.
‘The RACGP has concerns about the timeliness of investigations about registered health practitioners where immediate action has been taken in relation to those health practitioners,’ the submission reads.
‘While immediate action itself is often implemented swiftly, the subsequent investigation and resolution of these matters often extends far beyond what could reasonably be considered “as quickly as practicable”.
‘It appears AHPRA is allowed overly generous timeframes to determine how to respond to concerns raised about a practitioner.’
While the college acknowledges the complexity of some investigations, it argues that ‘current timeframes exceed reasonable expectations and appear inconsistent with the National Law’s requirements’.
‘Delays in progressing investigations also impact a practitioner’s ability to demonstrate recency of clinical practice to maintain their registration,’ the submission notes.
The feedback is part of an investigation, launched by the NHPO in 2024, into how processes related to practitioners who are subject to immediate action are working and whether improvements are needed, to ensure practitioners are being treated fairly.
‘Immediate action’ refers to a National Board’s decision to take action regarding a health practitioner’s registration if it reasonably believes they pose a serious risk to the public, or if it is in the public interest to do so.
Examples of this include placing conditions on a practitioner’s registration or suspending their registration.
Once an immediate action is taken, the relevant National Board must decide what further action to take. Options include investigating the matter, referring a matter to the relevant tribunal or panel, or requiring that the practitioner undertake a health or performance assessment.
The RACGP said it supports the core objective of the National Registration and Accreditation Scheme to protect the public by ensuring only health practitioners who are suitably trained and qualified, and practise in a competent and ethical manner are registered, and that ‘in some cases taking immediate action may be necessary’.
However, it maintains that the subsequent investigation and resolution of these matters is taking far too long.
In its submission, the college identifies several barriers to the timely finalisation of immediate action cases, including investigative delays and inefficiencies, multi-agency coordination challenges, and concurrent investigations.
‘Delays in timely finalisation of matters are experienced as a result of delays in AHPRA collecting relevant information in the course of an investigation,’ the submission reads.
‘These delays are often experienced due to AHPRA’s inability to source expert opinions in a timely manner. This can have a significant impact on practitioners and their patients, with appointments needing to be moved to accommodate these changes.
‘It appears that AHPRA does not prioritise investigations that relate to health practitioners that are the subject of immediate action restrictions.
‘AHPRA’s resources appear stretched, with investigators managing large caseloads across varying complexity levels. Cases involving immediate action should receive priority resourcing.’
The RACGP also raised concerns about procedural fairness in immediate action matters, including communication deficiencies, stigmatisation, financial implications and an insufficient recognition of consequences.
The college acknowledged that practitioners frequently report ‘inadequate communication’ about investigation progress leaving them in ‘prolonged uncertainty’ and leading to delays in engaging legal representation and expert witnesses.
‘The system appears poorly equipped to respond to the severe impacts of prolonged restrictions on practitioners’ mental health, careers, and livelihoods,’ the submission reads.
‘The impact of the regulatory system on practitioner wellbeing has been well documented, with several cases of notifications leading to suicide by those under investigation.
‘Practitioners must be referred to appropriate support services and provided with resources to assist them during this process.’
To ensure that immediate action cases are prioritised, the RACGP has proposed several changes for consideration. These include:
- the establishment of maximum timeframes for investigations
- the creation of expedited investigation pathways with specialised AHPRA resources to ensure a prompt resolution
- and, implementing interim review mechanisms to assess whether immediate action remains necessary based on information gathered to date.
The college also highlighted the need to consider appropriate clinical handover arrangements are in place, ensuring patient care is not disrupted when a practitioner is subject to immediate action, particularly when there is a lack of alternative practitioners located close by.
‘AHPRA and the National Boards must prioritise patient safety and care coordination to minimise disruptions and ensure patients can continue to access the care they need,’ the submission reads.
Meanwhile, the RACGP has also called for additional procedural safeguards, particularly for practitioners with health-related issues.
In addition to structured periodic reviews, it says there could be a ‘separation of health and professional conduct pathways’ to implement distinct processes for health-related and conduct-related concerns, with health matters managed through therapeutic frameworks where appropriate.
The NHPO says it sought submissions from health practitioners, health services and organisations, and others interested in informing its investigation.
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AHPRA immediate action National Health Practitioner Ombudsman NHPO
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